Science sub-issue cover: Ebola virus can hide in the brain and even persist for years after treatment

In a breakthrough study, scientists describe how the Ebola virus persists in certain parts of the body, reemerges and causes deadly disease even after long periods of treatment with monoclonal antibodies
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Their study, which used a nonhuman primate model of Ebola virus infection, appears on the cover of today's issue of Science Translational Medicine

Dr Xiankun (Kevin) Zeng, lead author of the paper, said that some recent outbreaks of Ebola virus disease in Africa have been associated with persistent infection in patients who survived previous outbreaks
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The 2021 outbreak of Ebola virus disease in Guinea has re-emerged in a persistent infection survivor of the last major outbreak at least five years ago

"Our study reveals, for the first time, the hidden location of Ebola in the brain and the pathology that leads to subsequently fatal recurrent Ebola-related disease in a non-human primate model," explained Zeng
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found that about 20 percent of monkeys who survived lethal Ebola exposure after treatment with monoclonal antibody therapy still had persistent Ebola infection -- particularly in the ventricular system, the cerebrospinal fluid Produced and circulated in this system, even when Ebola virus was cleared from all other organs

In particular, two monkeys recovered from Ebola-related disease after receiving antibody therapy, but developed severe clinical symptoms of Ebola virus infection and eventually died

According to the authors, human survivors of Ebola virus disease have experienced relapses
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For example, a British nurse who experienced a recurrence of Ebola in the brain developed meningoencephalitis nine months after recovering from severe Ebola disease

Over the past few years, Qinghong Zeng's team at the American Academy of Medicine has used nonhuman primate survivors as models to systematically study the persistence of the Ebola virus
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The study shows that although the virus has been cleared from other organs, it can hide and reside in specific regions of immune-privileged organs, such as the vitreous chamber of the eye, the vas deferens in the testes and the ventricular system of the brain mentioned in this study

"Persistent Ebola virus may reactivate in survivors and lead to disease recurrence, potentially leading to new outbreaks," said Jun Liu, PhD, of the Institute of Medicine of the American Academy of Medical Sciences
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Ebola virus is one of the deadliest infectious diseases known to man
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It remains a major threat in Africa, which has seen three outbreaks in 2021 alone, according to the World Health Organization

"Fortunately, with these approved vaccines and monoclonal antibody therapies, we are in a better position to control the outbreak, however, our study highlights the need for long-term follow-up of Ebola virus disease survivors , and even survivors who received therapeutic antibody therapy to prevent relapse
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This will help reduce the risk of disease re-emergence, while also helping to prevent further stigmatization of patients
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"

references:

Ebola Virus Persistence and Disease Recrudescence in the Brains of Antibody-Treated Nonhuman Primate Survivors.
Liu  et al .
, Sci.
Transl.
Med.
14, eabi5229 (2022) 9 February 2022.